Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://hdl.handle.net/1843/69175 |
Resumo: | Background and Objectives: To evaluate clinical and laboratorial variables associated with diagnosis of laboratory-confirmed sepsis associated with central venous catheter (CVC) in newborns. Methods: Prospective cohort study carried out in a reference neonatal unit from 2015 to 2017. Newborns using CVC were included and information were obtained from medical records. The outcome was considered an episode of laboratory-confirmed sepsis associated with CVC for evaluation of clinical and laboratorial variables. The SPSS version 20.0 program was utilized for statistical analysis. The study was approved by the ethics committee of institution. Results: A total of 191 newborns with CVC were identified, which 92 have had 95 episodes of suspected sepsis. Only 33 of them were considered laboratory-confirmed episodes of sepsis by the National Health Surveillance Agency of Brazil criteria, and 20 were considered laboratory-confirmed episodes of sepsis by the Centers for Disease Control and Prevention criteria. The immature/total segmented ratio (I/T ratio) was statistically significant in univariate and multivariate model as an independent variable associated with laboratory-confirmed sepsis associated with CVC (p=0.009). In cases confirmed by international criteria, hypothermia and hyperthermia remained as clinically significant changes in laboratory-confirmed CVC-associated sepsis in multivariate analysis. Conclusion: Higher immature/total neutrophils ratio, increased C-reactive protein and thermal instability are parameters that help in defining CVC-associated sepsis and may contribute to the decision on rational use of antimicrobials, considering the low sensitivity of blood cultures and isolation of skin contaminants in a single sample. |
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2024-06-12T20:54:54Z2024-06-12T20:54:54Z20221211152316-5324http://hdl.handle.net/1843/69175Background and Objectives: To evaluate clinical and laboratorial variables associated with diagnosis of laboratory-confirmed sepsis associated with central venous catheter (CVC) in newborns. Methods: Prospective cohort study carried out in a reference neonatal unit from 2015 to 2017. Newborns using CVC were included and information were obtained from medical records. The outcome was considered an episode of laboratory-confirmed sepsis associated with CVC for evaluation of clinical and laboratorial variables. The SPSS version 20.0 program was utilized for statistical analysis. The study was approved by the ethics committee of institution. Results: A total of 191 newborns with CVC were identified, which 92 have had 95 episodes of suspected sepsis. Only 33 of them were considered laboratory-confirmed episodes of sepsis by the National Health Surveillance Agency of Brazil criteria, and 20 were considered laboratory-confirmed episodes of sepsis by the Centers for Disease Control and Prevention criteria. The immature/total segmented ratio (I/T ratio) was statistically significant in univariate and multivariate model as an independent variable associated with laboratory-confirmed sepsis associated with CVC (p=0.009). In cases confirmed by international criteria, hypothermia and hyperthermia remained as clinically significant changes in laboratory-confirmed CVC-associated sepsis in multivariate analysis. Conclusion: Higher immature/total neutrophils ratio, increased C-reactive protein and thermal instability are parameters that help in defining CVC-associated sepsis and may contribute to the decision on rational use of antimicrobials, considering the low sensitivity of blood cultures and isolation of skin contaminants in a single sample.Justificativa e Objetivos - Avaliar variáveis clínicas e laboratoriais associadas ao diagnóstico de sepse laboratorialmente confirmada associada a cateter venoso central (CVC) em recém-nascidos. Método - Estudo de coorte prospectivo realizado em unidade neonatal de referência, de 2015 a 2017. Foram incluídos recém-nascidos em uso de cateter venoso central e as informações foram obtidas de prontuários. O desfecho foi considerado episódio de sepse laboratoriamente confirmada associada a CVC para comparação de variáveis clínicas e laboratoriais. Utilizou-se o programa SPSS versão 20.0 para análise estatística. O estudo foi aprovado pelo Comitê de Ética institucional. Resultados - Foram identificados 191 recém-nascidos com CVC; 92 deles apresentaram 95 episódios suspeitos de sepse. Entretanto, apenas 33 deles foram episódios de sepse laboratorialmente confirmada pelo critério ANVISA e 20 deles episódios de sepse laboratorialmente confirmada pelo critério do Centers for Disease Control and Prevention. Para casos confirmados pelos critérios nacionais, a relação neutrófilos imaturos pelo total de segmentados apresentou significância estatística em análise univariada e permaneceu em modelo multivariado como variável independente associada a sepse laboratorialmente confirmada associada a CVC (p=0,009). Para casos confirmados pelos critériosinternacionais, hipotermia e hipertermia permaneceram como alterações clínicas significativas de sepse laboratorialmente confirmada associada ao CVC em análise multivariada. Conclusão – Maior relação neutrófilos Imaturos/Totais, aumento de Proteína C-reativa e instabilidade térmica são parâmetros que auxiliam na definição de sepse associada a CVC e podem contribuir na decisão do uso racional de antimicrobianos, considerando a baixa sensibilidade de hemocultura e isolamento de contaminantes de pele em amostra única.FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas GeraisengUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE PEDIATRIAJournal of Infection ControlCateteres Venosos CentraisInfecçõesRecém-NascidoDiagnósticoUnidades de Terapia IntensivaCateter venoso centralInfecções associadas a cateterRecém-nascidoDiagnóstico de sepseUnidades de terapia intensiva neonatalClinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unitParâmetros clínicos e laboratoriais associados ao diagnóstico de sepse neonatal tardia laboratorialmente confirmada associada ao cateter venoso central em recémnascidos em unidade neonatal de referência.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://jic-abih.com.br/index.php/jic/article/view/778/0Caroliny Alves PessoaRoberta Maia Castro RomanelliRenata c BreddaBruno a CardosoDalila md LimaElaine Alvarenga de Almeida CarvalhoAloísio J. F. RibeiroMaria Cândida Ferrarez Bouzadaapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/69175/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALClinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit.pdfClinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit.pdfapplication/pdf876097https://repositorio.ufmg.br/bitstream/1843/69175/2/Clinical%20and%20laboratorial%20parameters%20related%20to%20the%20diagnosis%20of%20late%20onset%20neonatal%20sepsis%20laboratory-confirmed%20associated%20with%20central%20venous%20catheter%20in%20newborns%20in%20a%20reference%20neonatal%20unit.pdf7882655edffc2069f3e2bfccc96a21eaMD521843/691752024-06-12 17:54:55.038oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2024-06-12T20:54:55Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit |
dc.title.alternative.pt_BR.fl_str_mv |
Parâmetros clínicos e laboratoriais associados ao diagnóstico de sepse neonatal tardia laboratorialmente confirmada associada ao cateter venoso central em recémnascidos em unidade neonatal de referência. |
title |
Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit |
spellingShingle |
Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit Caroliny Alves Pessoa Cateter venoso central Infecções associadas a cateter Recém-nascido Diagnóstico de sepse Unidades de terapia intensiva neonatal Cateteres Venosos Centrais Infecções Recém-Nascido Diagnóstico Unidades de Terapia Intensiva |
title_short |
Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit |
title_full |
Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit |
title_fullStr |
Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit |
title_full_unstemmed |
Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit |
title_sort |
Clinical and laboratorial parameters related to the diagnosis of late onset neonatal sepsis laboratory-confirmed associated with central venous catheter in newborns in a reference neonatal unit |
author |
Caroliny Alves Pessoa |
author_facet |
Caroliny Alves Pessoa Roberta Maia Castro Romanelli Renata c Bredda Bruno a Cardoso Dalila md Lima Elaine Alvarenga de Almeida Carvalho Aloísio J. F. Ribeiro Maria Cândida Ferrarez Bouzada |
author_role |
author |
author2 |
Roberta Maia Castro Romanelli Renata c Bredda Bruno a Cardoso Dalila md Lima Elaine Alvarenga de Almeida Carvalho Aloísio J. F. Ribeiro Maria Cândida Ferrarez Bouzada |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Caroliny Alves Pessoa Roberta Maia Castro Romanelli Renata c Bredda Bruno a Cardoso Dalila md Lima Elaine Alvarenga de Almeida Carvalho Aloísio J. F. Ribeiro Maria Cândida Ferrarez Bouzada |
dc.subject.por.fl_str_mv |
Cateter venoso central Infecções associadas a cateter Recém-nascido Diagnóstico de sepse Unidades de terapia intensiva neonatal |
topic |
Cateter venoso central Infecções associadas a cateter Recém-nascido Diagnóstico de sepse Unidades de terapia intensiva neonatal Cateteres Venosos Centrais Infecções Recém-Nascido Diagnóstico Unidades de Terapia Intensiva |
dc.subject.other.pt_BR.fl_str_mv |
Cateteres Venosos Centrais Infecções Recém-Nascido Diagnóstico Unidades de Terapia Intensiva |
description |
Background and Objectives: To evaluate clinical and laboratorial variables associated with diagnosis of laboratory-confirmed sepsis associated with central venous catheter (CVC) in newborns. Methods: Prospective cohort study carried out in a reference neonatal unit from 2015 to 2017. Newborns using CVC were included and information were obtained from medical records. The outcome was considered an episode of laboratory-confirmed sepsis associated with CVC for evaluation of clinical and laboratorial variables. The SPSS version 20.0 program was utilized for statistical analysis. The study was approved by the ethics committee of institution. Results: A total of 191 newborns with CVC were identified, which 92 have had 95 episodes of suspected sepsis. Only 33 of them were considered laboratory-confirmed episodes of sepsis by the National Health Surveillance Agency of Brazil criteria, and 20 were considered laboratory-confirmed episodes of sepsis by the Centers for Disease Control and Prevention criteria. The immature/total segmented ratio (I/T ratio) was statistically significant in univariate and multivariate model as an independent variable associated with laboratory-confirmed sepsis associated with CVC (p=0.009). In cases confirmed by international criteria, hypothermia and hyperthermia remained as clinically significant changes in laboratory-confirmed CVC-associated sepsis in multivariate analysis. Conclusion: Higher immature/total neutrophils ratio, increased C-reactive protein and thermal instability are parameters that help in defining CVC-associated sepsis and may contribute to the decision on rational use of antimicrobials, considering the low sensitivity of blood cultures and isolation of skin contaminants in a single sample. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022 |
dc.date.accessioned.fl_str_mv |
2024-06-12T20:54:54Z |
dc.date.available.fl_str_mv |
2024-06-12T20:54:54Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/69175 |
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2316-5324 |
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2316-5324 |
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http://hdl.handle.net/1843/69175 |
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eng |
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eng |
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Journal of Infection Control |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
dc.publisher.department.fl_str_mv |
MED - DEPARTAMENTO DE PEDIATRIA |
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Universidade Federal de Minas Gerais |
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reponame:Repositório Institucional da UFMG instname:Universidade Federal de Minas Gerais (UFMG) instacron:UFMG |
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UFMG |
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